Rich Anna L
Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Campus, Nottingham, UK.
J Thorac Dis. 2020 Dec;12(12):7531-7535. doi: 10.21037/jtd-2019-thym-02.
Thymic tumours are a heterogeneous group of malignancies with a range of clinical presentations. The most common types are thymoma and thymic carcinoma, but overall it remains a rare cancer, and one without a clear aetiology. In this review of the epidemiology of the disease, the relationship between sex, age, and ethnicity is reviewed, along with limited evidence on the genetics of the condition. In terms of risk factors and potential causative factors, environmental exposures such as tobacco, radiation, alcohol, or diet, seem to be irrelevant, but there is some evidence linking the development of thymoma and thymic carcinoma with viral conditions, including Epstein Barr Virus. But data is not conclusive, and in the absence of large patient numbers, it is difficult to prove causation. There has been good research looking at the link between thymoma and other malignancies, either before or after the diagnosis. There does not appear to be a significant increased likelihood of thymoma following other malignancies. But, there is a suggestion, in several papers, that there is an increased risk of other malignancies following the diagnosis of thymoma, although the magnitude of this risk is disputed. There does appear to be an increased risk of non-Hodgkins Lymphoma after a diagnosis of thymoma, and this could be related to a disruption in T-cell function caused by either the disease process or the treatment directed at the thymoma. In summary though, it is a rare malignant process with a variety of presentations, often limited to the anterior mediastinum, and without an aggressive disease profile.
胸腺肿瘤是一组异质性恶性肿瘤,临床表现多样。最常见的类型是胸腺瘤和胸腺 carcinoma,但总体而言,它仍然是一种罕见的癌症,且病因不明。在对该疾病流行病学的综述中,回顾了性别、年龄和种族之间的关系,以及关于该疾病遗传学的有限证据。在风险因素和潜在致病因素方面,烟草、辐射、酒精或饮食等环境暴露似乎无关,但有一些证据将胸腺瘤和胸腺 carcinoma 的发生与病毒感染相关联,包括爱泼斯坦 - 巴尔病毒。但数据并不确凿,而且由于缺乏大量患者,很难证明因果关系。已经有关于胸腺瘤与其他恶性肿瘤之间关联的良好研究,无论是在诊断之前还是之后。在其他恶性肿瘤之后发生胸腺瘤的可能性似乎没有显著增加。但是,有几篇论文表明,在胸腺瘤诊断之后发生其他恶性肿瘤的风险增加,尽管这种风险的程度存在争议。在胸腺瘤诊断之后,非霍奇金淋巴瘤的风险确实似乎增加了,这可能与疾病过程或针对胸腺瘤的治疗导致的 T 细胞功能紊乱有关。不过,总的来说,它是一种罕见的恶性疾病,有多种表现形式,通常局限于前纵隔,且病情不具侵袭性。